Pediatric and Adult Congenital Heart Disease Center.
Health Professions Research and Development Unit, IRCCS Policlinico San Donato, San Donato Milanese, Milan, Italy.
J Cardiovasc Med (Hagerstown). 2019 Apr;20(4):253-260. doi: 10.2459/JCM.0000000000000770.
The aim of this study was to assess the impact of a transition clinic model on adolescent congenital heart disease (CHD) patients' health perception outcomes. The transition clinic model consists of multidisciplinary standardized interventions to educate and support CHD patients and represents a key element in the adequate delivery of care to these individuals during their transition from childhood to adulthood. Currently, empirical data regarding the impact of transition clinic models on the improvement of health perceptions in CHD adolescent patients are lacking.
A quasi-experimental design was employed. Quality of life, satisfaction, health perceptions and knowledge were assessed at the time of enrolment (T0) and a year after enrolment (T1), respectively. During the follow-up period, the patients enrolled (aged 11-18 years) were involved in the CHD-specific transition clinic model (CHD-TC).
A sample of 224 CHD adolescents was enrolled (60.7% boys; mean age: 14.84 ± 1.78 years). According to Warnes' classification, 22% of patients had simple heart defect, 56% showed moderate complexity and 22% demonstrated severe complexity. The overall results suggested a good impact of the CHD-TC on adolescents' outcomes, detailing in T1 the occurrence of a reduction of pain (P < 0.001) and anxiety (P < 0.001) and an improvement of knowledge (P < 0.001), life satisfaction (P < 0.001), perception of health status (P < 0.001) and quality of life (P < 0.001).
The CHD-TC seems to provide high-quality care to the patient by way of a multidisciplinary team. The results of the present study are encouraging and confirm the need to create multidisciplinary standardized interventions in order to educate and support the delivery of care for CHD adolescents and their families.
本研究旨在评估过渡诊所模式对青少年先天性心脏病（CHD）患者健康感知结果的影响。过渡诊所模式由多学科标准化干预措施组成，用于教育和支持 CHD 患者，是为这些患者从儿童期过渡到成年期提供适当护理的关键要素。目前，关于过渡诊所模式对改善 CHD 青少年患者健康感知的影响的实证数据尚缺乏。
采用准实验设计。分别在入组时（T0）和入组后 1 年（T1）评估生活质量、满意度、健康感知和知识。在随访期间，入组的患者（年龄 11-18 岁）参与了特定于 CHD 的过渡诊所模式（CHD-TC）。
共纳入 224 名 CHD 青少年（60.7%为男性；平均年龄：14.84±1.78 岁）。根据 Warnes 分类，22%的患者有简单的心脏缺陷，56%表现为中度复杂性，22%表现为重度复杂性。总体结果表明，CHD-TC 对青少年结局有良好的影响，详细情况见 T1 时疼痛（P<0.001）和焦虑（P<0.001）减轻，知识（P<0.001）、生活满意度（P<0.001）、健康状况感知（P<0.001）和生活质量（P<0.001）提高。
CHD-TC 似乎通过多学科团队为患者提供高质量的护理。本研究结果令人鼓舞，证实需要创建多学科标准化干预措施，以教育和支持 CHD 青少年及其家庭的护理提供。
